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169 Martin Ave Ephrata PA 17522-1734 | |
(717) 733-0311 | |
(717) 738-6675 |
Full Name | |
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Speciality | Clinic/center |
Location | 169 Martin Ave, Ephrata, Pennsylvania |
Authorized Official Name and Position | Tina Citro (VP & PRESIDENT) |
Authorized Official Contact | 7177386407 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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601 Memory Ln York PA 17402-2231 Ph: (717) 851-1405 | 169 Martin Ave Ephrata PA 17522-1734 Ph: (717) 733-0311 |
NPI Number | 1548423684 |
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Provider Enumeration Date | 07/09/2008 |
Last Update Date | 10/16/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1548423684 | NPI | - | NPPES |
1007464680079 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |
261QA1903X | Clinic/center - Ambulatory Surgical | (* (Not Available)) | Secondary |